The effectiveness of wet-cupping for nonspecific low back pain in Iran: a randomized controlled trial. Complement Ther Med

Department of Anesthesiology, Critical Care and Pain Management, Pain research center, Kermanshah University of Medical Sciences, Iran.
Complementary therapies in medicine (Impact Factor: 1.55). 01/2009; 17(1):9-15. DOI: 10.1016/j.ctim.2008.05.003
Source: PubMed


To determine the efficacy of wet-cupping for treating persistent nonspecific low back pain.
Wet-cupping therapy is one of the oldest known medical techniques. It is still used in several contemporary societies. Very minimal empirical study has been conducted on its efficacy.
Randomized controlled trial with two parallel groups. Patients in the experimental group were offered the option of referral to the wet-cupping service; all accepted that option. The control group received usual care.
Medical clinic in Kermanshah, Iran.
In total, 98 patients aged 17-68 years with nonspecific low back pain; 48 were randomly assigned to experimental group and 50 to the control group.
Patients in the experimental group were prescribed a series of three staged wet-cupping treatments, placed at 3 days intervals (i.e., 0, 3, and 6 days). Patients in the control group received usual care from their general practitioner.
Three outcomes assessed at baseline and again 3 months following intervention: the McGill Present Pain Index, Oswestry Pain Disability Index, and the Medication Quantification Scale.
Wet-cupping care was associated with clinically significant improvement at 3-month follow-up. The experimental group who received wet-cupping care had significantly lower levels of pain intensity ([95% confidence interval (CI) 1.72-2.60] mean difference=2.17, p<0.01), pain-related disability (95% CI=11.18-18.82, means difference=14.99, p<0.01), and medication use (95% CI=3.60-9.50, mean difference=6.55, p<0.01) than the control group. The differences in all three measures were maintained after controlling for age, gender, and duration of lower back pain in regression models (p<0.01).
Traditional wet-cupping care delivered in a primary care setting was safe and acceptable to patients with nonspecific low back pain. Wet-cupping care was significantly more effective in reducing bodily pain than usual care at 3-month follow-up.

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Available from: Alireza Ahmadi, Oct 06, 2015
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    • "From here it may be said that current research findings are promising, as it is the case with other research works, where results showed cupping therapy fruitful not only for pain control, but for improvement of quality of life and the minimizing of all potential risks of treatment (Huang et al., 2013). It is clear that the present findings not solely lessen and desensitize chronic back pain, rather, they are in line with many other earlier research findings such as Hänninen and Vaskilampi (1982), Li et al. (2006), Chen (2006), Chen (2007), Farhadi et al. (2009) and Jang et al. (2010). "
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    ABSTRACT: The present study is designed to determine whether chronic pain syndrome (lower and upper back pain) before and after cupping is the same or there are significant treatment differences. Perception due to cupping of here and now pain sensation; sensation of pain at worst conditions; sensation of pain at best conditions; and tolerated sensation of pain; all before and after cupping were rated on 0 to 10 pain scale. It was hypothesized that there is a significant statistical difference before and after cupping, and cupping is effective in lessening and desensitizing chronic pain among lower and upper back pain subjects. Subjects were drawn on convenience sampling basis, where 95 males and females were recruited for the purpose of investigation. Results indicate that cupping therapy is effective procedure in reducing and alleviating chronic pain, where true statistical differences were obtained. It was found after the study that cupping therapy as an alternative medical technique is an effective and fruitful enough either for the management of upper and lower back pain or the control of such annoying medical conditions.
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    • "9 - Al Bedah et al , 2011 : 12 - 6 . 10 - Farhadi et al , 2009 : 9 – 15 . 11 - Michalsen et al , 2009 : 601 – 608 . "
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    ABSTRACT: Dry cupping is one of the main procedures in many traditional medicine systems all around the world with its root in antiquity. Traditional method of dry cupping is depend-ed on practitioner proficiency and can lead to skin burn if the practitioner is a beginner. On the other hand, Zahrawi (11th century AD), the Muslim physician from Andulus (current Spain) presented two novel forms of cup for cupping to improve and correct cupping problems. In this regards, based on the model described in Al-Tasreef, we tried to redesign and manufacture the tools. These tools were made from galvanized iron owing to its nonconductivity of heat. Zahrawi models were compared with traditional model (with the same material and size) by negative pressure of mercury as well as qualitative test performed by a traditional practitioner. The results showed the superior-ity of Zahrawi's models (9792Pa and 10200Pa) over the traditional model, displaying a better and more stable vacuum pressure (mean: 8704 Pa with variation in repeat the test). Furthermore, the introduced models are user friendly; i.e., every practitioner, even the beginner without specialized skill, may work with them easily. Therefore, the new model is suggested for dry cupping.
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    • "However, recent clinical studies have reported positive results of cupping in patients with musculoskeletal diseases e.g. lower back pain [6], carpal tunnel syndrome [7], brachialgia paresthetica nocturna [8], cancer pain [9] and chronic neck pain [10-12]. In China Cupping is widely used and two systematic reviews were recently published about the results [13,14]. "
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    ABSTRACT: Cupping is used in various traditional medicine forms to relieve pain in musculoskeletal diseases. The aim of this study was to investigate the effectiveness of cupping in relieving the symptoms of knee osteoarthritis (OA). In a two-group, randomized controlled exploratory pilot study patients with a clinically and radiological confirmed knee OA (Kellgren-Lawrence Grading Scale: 2-4) and a pain intensity > 40 mm on a 100 mm visual analogue scale (VAS) were included. 40 Patients were randomized to either 8 sessions of pulsatile dry cupping within 4 weeks or no intervention (control). Paracetamol was allowed on demand for both groups. Outcomes were the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, the pain intensity on a VAS (0 mm = no pain to 100 mm = maximum intensity) and Quality of Life (SF-36) 4 and 12 weeks after randomization. Use of Paracetamol was documented within the 4-week treatment period. Analyses were performed by analysis of covariance adjusting for the baseline value for each outcome. 21 patients were allocated to the cupping group (5 male; mean age 68 ± SD 7.2) and 19 to the control group (8 male; 69 ± 6.8). After 4 weeks the WOMAC global score improved significantly more in the cupping group with a mean of 27.7 (95% confidence interval 22.1; 33.3) compared to 42.2 (36.3; 48.1) in the control group (p = 0.001). After 12 weeks the WOMAC global score were still significantly different in favor for cupping (31.0 (24.9; 37.2) vs. 40.8 (34.4; 47.3) p = 0.032), however the WOMAC subscores for pain and stiffness were not significant anymore. Significantly better outcomes in the cupping group were also observed for pain intensity on VAS and for the SF-36 Physical Component Scale compared to the control group after 4 and 12 weeks. No significant difference was observed for the SF-36 Mental Component Scale and the total number of consumed Paracetamol tablets between both groups (mean 9.1, SD ± 20.0 vs. 11.5 ± 15.9). In this exploratory study dry cupping with a pulsatile cupping device relieved symptoms of knee OA compared to no intervention. Further studies comparing cupping with active treatments are needed. Trial registration Identifier: NCT01057043
    BMC Complementary and Alternative Medicine 10/2012; 12(1):184. DOI:10.1186/1472-6882-12-184 · 2.02 Impact Factor
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